HomeMy WebLinkAbout2005-P08548 - attached deck , , •
PERMIT
C�TY �F �R�N� Permit Number:
2750 Kelley Parkway- PO Box 66 P08548
Crystal Bay, Minnesota 55323 P@PI'Y11t Typ@: Addirion/RemodeURepair
(952) 249-4600 Date Issued: ai�i2oos
SITE ADDRESS: 4590 North Arm Dr W
Mound,MN 55364
PID: 06-117-23-24-0016
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residenrial Construcrion Type VN
Pernut Class: Building Census Code 434
Permit Type: Addirion/RemodeURepair Pernut Sub-type(s): Deck-Attached
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
FEE SUMMARY: Pemut Fee: $ 125.25 Valuation: $ 6,000.00
Plan Review Fee: $ 81.38
State Surcharge Fee: $ 3.50
TOTAL FEE: $ 210.13
APPLICANT: 7imNoreen Construcrion OWNER: Barry&Janice Haglund
497 Kuntz Dr. 4590 North Arm Dr W
Independence,MN 55359 Mound,NIN 55364
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
G� �
IC P ITEE SIGNATURE ISSUED BY SIGNATCTRE
Covies: 1-File(SiQnitures Required),1-Auulicant 1-Monthlv Revorts, 1-Assessin�, 1-Finance Page 1
Total Fee: $ � _ Date Received: �'a8���
Entered By: � � Permit#: AD�JS��
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please pri�zt all informatio�i)
THE APPLICANT IS: (circle one) OWNER OR CONTR.ACTOR
JOB SITE ADDRESS: �� ��-' ��/�Jr't� �rn �!'. ZIP: :�^J� � � (
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes [�No If yes, a special event permit is required with Police Department and City
Council approva160 days prior to tlze eve�zt. Non permitted events will not
be allowed.
NAME OF OWNER: ��r►�`�/ �' �JCcn� f'� �4I�,n� PHONE: (home)�-5�- y7�'����
/`� '� �-l� (work) �-/S�2- y7�- S;7/`�
MAILING ADDRESS: �S �G �'v' ��-�%�r-CITY: ��5 3 > ZIP: �,�o�
,
CONTRACTOR: ���c'�d�`E��+'i �v1.S 1 � PHONE: �l� �o�G�-- �J����'
CONTACT PERSON: , li h� /Vo<�'�r�-1 MOBILE/PAGER: S�t�,,� _
MAILING ADDRESS: Yq� K�Yt�Z I�►�- CITY: -f-� �. �ZIP: .S S3.S�-�
STATE LICENSE: # �O 3 �%�l'{ 3�3i/oS
ARCHITECT/ENGINEER: �C�►''���� �,v�y�. PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Accessory Structure
Addition Move
RemodeUAlteration Land Alteration
PROPOSED WORK(describe in detai�: l� �l\ G'tc���i I�/U C�
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ � C�--J� ��'
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate;that the
work will be in conformance with the ordinances and codes of the City and with the State Building Code; that I
understand this is not a permit and work is not to start without a permit;and that the work will be in accordance with
the approved plan.
APPLICANT'S SIGNATURE: ��,.�, � DATE: � � � G '
,
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd.l. Type of data. The rlghts of individual on whom the data is stored or to be stored shall be as set fortd in this section.
Subd.2. Information required to be given individual. An individual asked to suppiy private or contidential data concerning himself shall be
informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b)
whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplyfng or refusing to supply
private or confidential data;and(d)the identity of other persons or entities suthorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply investfgative data,pursuant to section 13.82,subdivision 5,to a law enforcement ofFcer.
The commissioner of revenue mav place the notice repuired under this subdivision in the individual income tax or orooertv tax refund
instructions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsibie authority,an individual shall be informed whether he is the subject of
stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who is the subJect of
stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed of the content and
meaning of that data. After an individual has been shown the private data and informed of Its meaning,the data need not be disclosed to him for six
months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The
responsible authority shall provide copies of the private or public data upon request by the Individual subject of the data. The responsible authority may
require the requesting person to pay the actual costs of making,certifying,and compiling the copies.
The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdiviston,or within five days ofthe
date of the request,excluding Saturdays,Sundays and legal ho8days,if immediate compliance is not possible.If he cannot comply with the requestwithin
that time,he shali so inform the individual,and may have an additional five days within which to comply with the request,excludingSaturdsys,Sundays
and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest t6e accuracy or completeness of public or private data
wncern(ng himself. To exercise this right,an individual shali notify in writing the responsible authority describing the nature of the disagreement.The
responsible suthority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of
inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct.Data in
dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S.13.04,Subd.2,"Rights of subjects of data",we would like to inform you that your request
for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or
confidential information.
You are notified that:
1. The information you furnish will be used to determine your qualification for the permit or license requested.
2. You may refuse to supply data,but refusal may require that the City deny the permit or license.
3. The information may be shared with other local,state or federal agencies to the estent necessary to process
the permit or license.
4. If your requested permit or license requires Council action to approve, some information may become
public.
5. You have certain rights under M.S.13.04(available upon request)to review private data on yourself.
6. Your full name is required to process this application or permit.
First Middle Last
Address
City State Zip Phone
I understand y rights as stated above.
� V =
Signat
„ �
CHECK OFF LIST FOR ISSUANCE OF PERtti.tITS
FOR OFFICE USE ONL Y �
ADDRESS OR LEGAL: y5�ic� �vo2n-t R/1� �ll.
, �
PID:
DESCRIPTION OF YVORK: — ,
------------------------------------- -;- -- -
------------------------------------ --
ZO1YItVGREV1Ey1�BY: DATEAPPROVED: `/- I- �� �
BUILDItYGREVIEWBY: DATEAPPROF'ED: `1— �— os
---------------------------------- ---
FEES TO BE CHARGED: tLlisc. Fees Calcecfated By:
PER1�fIT Yes �/ No
PLA�V REVIEGV Yes �/' 1Vo SEYVER GONiVECTIOrV
STATE SURCHARGE Yes � tVo YVATER GO�1 tNECTlOtV
. It�IVESTIG.4Tl01V FEE Yes tVo PARK FEE
SAG ,Yes �vo SITE INSPECTIOtV
Num6er of SAC U�tits OTHER (specify)
----------------------------------------------------------------------
2'O�VIIYG CHEC,£�'LIST zoning Disd•icr:
Fire Depni�tmerrt: Post O�ce: Sdtoo(District: _..
Got.�1ren: S9.ft• --- s{cres 6Vidth Depth
Su�-vey Su6niitted: Yes� No Date of Sc�rvey: DN �'��-�:
Propasecf Setbncks: �
Froru(Lah.e): 24Z � Riglit Side: �2-1 sTn�et�r c:
Rear(Sh•eet): /-� Left Side: I Z” �
Adjncent Str•uctceres: iq-TS►� Y[retlnnd: N (�9
Building Height: Def. Hgt. �— Peak Hgt. �
Lot Coverage: � I\( ��– — ,
Grac[ing: StRf)`':tpp►•oval Date: — gy: Cotcncil Approval DRte:
Septic: Stnff�lpproval Date: ' BY�
Zoning File: # '�_ Resolution: # ResoIc�lion Dnte: _
Sltoreland Dist�•ict: (/V�
Avg.Setbnck: __ Bluff Setback: Lot Cover�age:
� Esisting Proposed
HRrdco�er: 0-75'
75-250'
250-500' �
500-l000' �
Hardcover Variance Requir•ed: Yes No' Date of Cvuncit tipproval:
; .R,E11�If1R.KS(irt Isouse): � '';
` : , .;
, ; ,
,
31 - �
F� '� �
.. �
, �, .
. . ., , ' �� � ,, I .� : � � ` ` " ,; � .. 4 4 b.��, °� 'n
. � ♦ �
B UILDItVG.RE VXE�Y CHECh'LIST �
IIBC: 2• 3 ' � CONSTRUCTIO�Y"TYPE: �l�
Sq Footc�ge .�Pei•Sq Ft�
Base��ie�tt .r =
!st Flao,• x =
?nd Floor . _
Garc�e t
c =
TOTAG
Estirnated Catstructio�c Va(i�e: S (�,Ooo ,�
Inspectioris Required: if'ork Requi�•irt,Separate Perntits:
Site Plumbing � Fire
Hardco��er Rernoval A�fechctnical yYate�•Cainection
_ Z Footing Septic Setiver•Connection
K F�"amiu� Fireplace Larvn h•rigatian
lnsulatiat � (Mc�.son�}�) Other•
Waf!Board (lbtfg.) 4Ve!!(St�te Per�itit)
_�Final Gradiitg/Fillin,� Electricaf(State Permit)
Other '
IZ.�EttiIA.Rl'iS(XN HO USE): �
ItE f?E T-V B Y OTlYERS: DATE:
:Lccess: Existing rYew
�ccess Approval: Date By:
1ZEM�1Rh'S(TO BE NOTED O�V PE,i21Y,t.CT):
32
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�� D E TIME �
CITY OF ORONO �w ��
INSPECTION SCHEDULED ��� �
PERMIT NO. � COMPLETED
ADDRESS ��D �U�(/lYi ��
OWNER CONTR. ���?/UD'Y�P�
TELEPHONE NO. �O�a ��� 3g�o
� DESCRIPTION t�GY�� �'1 �S' —
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
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W� WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the n xt inspection 24 hours in advance. (g52) 249-46��
OwnerlContra ite:
Inspector.
White Copy/lnspector's ile Canary CopylSite Notice
,
���� �
��i� �� DATE �,TIME
CITY OF ORONO CALLED IN , �� /�'r�%
INSPECTION NOTIC�, scHE�u�Eo .2 -> �'�'> �`;-=-�-•= }
PERMIT NO._�� C � 1 �4��I COMPLETED �
L=� �..� � ^ �
ADDRESS ? i l-� ��� t��/� /y 1 �1��
OWNER CONTR: i�� i.����>d'��l-y �
c�%
TELEPHONENO. ���� � �-��C� � ��CQ L.-
� DESCRIPTION Iy�� l��G� � � �,�..� L' lL.
�
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q�INAL 14 SEWER HOOK-UP 06 PROGRESS
� 7 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBWG RI 23 SEPTIC FINAL .' 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOU DATION/REMOVAL ,
� OWNER/CONTRACTOR TO MEET YOU:_Y�S NO � ���"�I� `� �E�t �(
� COMMENTS:
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� WORK SATISFACTORY:PROCEED PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN
INSPECTOR W1LL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION RE�UIRED.CALlTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-4600
OwnerlContr o ite:
Inspector. '
Whiie Copyllnspector's File Canary Copy/Site Notice
r------------------------:-'/------ ,
. -------------
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-� LEGAL DESCRIPTION OF
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� �� Lot 2, Block 1 , NORTH
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� This survey in�tends t
L � described property, t
\ garage , porch, deck ,
of a proposed additio